Spie Press Book

Multiple commercial femtosecond lasers have been cleared for use by the US Food and Drug Administration for ophthalmic surgery, including the creation of corneal flaps in LASIK surgery. Optical coherence tomography (OCT) is an established medical imaging technique that uses light to capture micrometer-resolution, three-dimensional images from within optical scattering media (e.g., biological tissue). The combination of femtosecond laser surgery and OCT imaging is useful to provide simultaneous guide to the development of next-generation femtosecond surgical lasers in cataract surgery and to explore novel femtosecond-laser surgical strategies. This Spotlight explains the principles of OCT-guided femtosecond-laser cataract surgery.

Book Details

Date Published: 31 March 2017Pages: 30ISBN: 9781510610866Volume: SL27

Table of Contents

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1 Cataracts and Surgery

1.1 Lens structure

1.2 Cataracts

1.3 Surgery

2 Physical Concepts of Femtosecond-Laser-Assisted Surgery

2.1 Lasers

2.2 All-solid-state chirped-pulse-amplification femtosecond laser

2.3 Laser/tissue interactions

2.3.1 Photochemical interaction

2.3.2 Thermal interaction

2.3.3 Photoablation

2.3.4 Plasma-induced ablation

2.3.5 Photodisruption

2.4 Optical coherence tomography in ophthalmic applications

3 OCT-Guided Femtosecond Laser Cataract Surgery

3.1 Commercially available femtosecond lasers

3.1.1 LenSx

3.1.2 Catalys

3.1.3 LensAR

3.1.4 Victus

3.1.5 Femto LDV

3.2 Surgery procedures

3.2.1 Planning

3.2.2 Engagement

3.2.3 Visualization and customization

3.2.4 Treatment

3.3 Benefits

3.3.1 Corneal incision

3.3.2 Capsulotomy

3.3.3 Lens fragmentation

3.3.4 Other benefits

3.4 Safety

3.5 Summary

4 Acknowledgments

References

Preface

Multiple commercial femtosecond lasers have been cleared for use by the U.S. Food and Drug Administration for ophthalmic surgery, including for the use of creating corneal flaps in laser in situ keratomileusis (LASIK) surgery. The newest
application of femtosecond lasers in ophthalmology is cataract surgery. A traditional microscope is used to check the flap-cutting effect during LASIK surgery in a clinic. Due to the depth of the human lens, it is difficult to show the details
of laser cutting in a patient's eye during cataract surgery with traditional microscopy. Optical coherence tomography (OCT) is an established medical imaging technique that uses light to capture micrometer-resolution, three-dimensional images from within optical scattering media (e.g., biological tissue). It is widely used, for example, to obtain high-resolution images of the anterior segment of the eye and the retina, which can, for example, provide a straightforward method of assessing axonal integrity in multiple sclerosis.

Currently, there are a few lasers at or near the point of commercial release, including LenSx (Alcon Laboratories Inc., Fort Worth, Texas), Catalys (Abbott Medical Optics, Santa Ana, California), LensAR (LensARInc, Orlando, Florida), Victus (Technolas Perfect Vision and Bausch & Lomb, Rochester, New York), and Femto LDV (Ziemer Ophthalmic Systems AG, Port, Switzerland). All laser systems share a common platform - which includes an anterior-segment imaging system, patient interface, and femtosecond laser to image - to calculate and deliver the laser pulses.